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Concerns over radiation exposure may overshadow life-saving benefits of cardiac imaging tests
Date:5/10/2010

benefits (e.g., correct diagnosis, improved survival) of cardiac imaging with ionizing radiation based on a review of the evidence; although authors argue against widespread use of SPECT or CT angiography in asymptomatic individuals, they believe benefits of cardiac imaging are especially evident for symptomatic patients, those at high risk for heart disease, older patients and men. Authors present charted data not previously published showing the cumulative risk of cancer in women occurring 1) naturally, 2) due to background radiation and 3) due to annual cardiac imaging beginning at age 40 and continuing until age 80, which shows the natural risk to be much higher.

  • Efforts by the cardiac imaging community to lower risks of radiation exposure and promote responsible use of this young technology and the need for standards that incorporate radiation exposure optimization based on the clinical indication as well as patient characteristics into scan protocol selection. Authors state that only with such a comprehensive, individualized approach to the patient can cardiovascular CT hope to provide a benefit to the patient that outweighs the potential risk.

  • Challenges of measuring radiation dose in nuclear imaging procedures; authors state that average risks, which are based on population studies, can be difficult to apply to individual patient given complexity.

What is needed moving forward?

Recent advances in limiting radiation dose levels through quality imaging, technological advances and guidelines, such as the American College of Cardiology's Appropriate Use Criteria, as well as keeping doses as low as reasonably appropriate (referred to as ALARA), are making a difference.

Authors stress there is a need for standardized measures for radiation exposure, long-term follow up of patients to better understand the safety profile in term of estimating cancer risk and cardiac benefits, especially among
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Contact: Amanda Jekowsky
ajekowsk@acc.org
202-375-6645
American College of Cardiology
Source:Eurekalert

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